Definition Polycystic ovarian syndrome (PCOS) is a disorder that results in abnormal hormone levels in a woman. In a normal ovary, a single egg develops and is released during ovulation each month. A polycystic ovary will have many eggs that are never released.
What is going on in the body? Polycystic ovarian syndrome often begins with puberty and worsens with time. The cause of PCOS has not yet been completely identified. The symptoms of PCOS are related to an excess of the hormone androgen. This hormone can cause male features such as facial hair and male-pattern baldness in women. Polycystic ovaries may be normal in size, or they may be enlarged, with smooth, thick coverings.
What are the signs and symptoms of the disease? The symptoms of polycystic ovarian syndrome include:
Ovarian cysts may sometimes rupture, although this is rare. They may also start to twist. This can result in sudden pain in the abdomen, bloating, and a feeling of stiffness in the abdomen.
What are the causes and risks of the disease? The exact cause of PCOS is not clear. Some of the possible causes include:
an excess release in the hormone androgen
certain genetic disorders, such as inherited metabolic disorders. Some metabolic conditions, such as diabetes, may cause too much insulin to circulate in the body. Improper amounts of insulin in the body can result in inadequate levels of the hormones that control menstruation and ovulation.
genetic disorders that cause an increase in the production of testosterone
certain medications, such as those used for seizure disorders or mood disorders
What can be done to prevent the disease? There is no known way to prevent polycystic ovarian syndrome.
How is the disease diagnosed? Many tools can be used to diagnosis polycystic ovarian syndrome. The doctor will take a history of the woman's symptoms. A pelvic examination may reveal enlarged ovaries, as well as other symptoms of the syndrome. Ovarian cysts may be detected using ultrasound.
Laparoscopy, or the placement of a scope through a small incision in the abdomen, can be used to look directly at the ovaries. A biopsy of the ovary may be performed. This involves taking a small sample of ovarian tissue to be checked in a laboratory. Blood and urine tests may be used to check hormone levels.
What are the long-term effects of the disease? The long-term effects of polycystic ovarian syndrome depend on the women's condition and her response to treatment, but may include:
endometrial hyperplasia, or a buildup of cells that line the uterus. Hyperplasia can lead to a higher risk of cancer of the uterus later in life.
What are the risks to others? Polycystic ovarian syndrome is not contagious, and poses no risk to others.
What are the treatments for the disease? There are many ways to treat polycystic ovarian syndrome, depending on a woman's symptoms. Treatment can include:
oral contraceptives and progesterone to regulate menstrual periods and reduce male hormone levels
spironolactone, a mild diuretic that blocks the effects of male hormones
Newer treatments focus on lowering insulin levels in the blood. Lowering insulin levels may help reduce the production of male hormones. It may also lessen the symptoms of PCOS. Metformin is one medication that has been used for this.
What are the side effects of the treatments? The risks of surgery include bleeding, infection, and allergic reaction to the anaesthesia. Medication side effects will vary, but include allergic reactions.
What happens after treatment for the disease? The symptoms of polycystic ovarian syndrome can often be managed over time with proper treatment.
How is the disease monitored? A woman's doctor will monitor her condition with regular pelvic examinations and other tests. Any new or worsening symptoms should be reported to the doctor.
Author: Barbara Mallari, RN, BSN, PHN Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
